Common Menopause Symptoms and How to Treat Them

New hot flash medications. Last spring, the Food and Drug Administration (FDA) approved a first-of-its-kind treatment for hot flashes. The pill, Veozah (fezolinetant), targets the part of the brain that helps regulate a person’s body temperature. (Changes in estrogen levels during menopause affect this area of the brain, causing hot flashes.)

Loeb-Zeitlin says so far the medication seems to be “really effective.” And it’s been a great option for many women who are not good candidates for hormone therapy, says Wen Shen, M.D., codirector of the Women’s Wellness & Healthy Aging Program and associate professor of gynecology and obstetrics at Johns Hopkins Medicine. “So, for a lot of my patients, it’s been a game changer.”

The issue, doctors say, is that a lot of insurance companies aren’t covering it yet, though Shen points out that the drugmaker does offer a coupon that can help offset out-of-pocket costs. 

There could be more medications like this in the near future. Pharmaceutical company Bayer recently announced its nonhormone drug candidate that is similar to Veozah eased hot flashes and improved sleep in clinical trial participants. Stay tuned.

Other nonhormonal medications. Beyond this new class of hot-flash medications, there are other nonhormonal medications that can help with menopause symptoms. Paroxetine, an antidepressant that belongs to a class of medications known as selective serotonin-reuptake inhibitors (SSRI), is FDA-approved for the treatment of hot flashes.  

“It can lessen hot flashes, help some of the mood changes that happen with menopause, and even can help women sleep better,” Loeb-Zeitlin says. “And so that’s a great option for women who either can’t or won’t use hormone therapy.”

Doctors also sometimes prescribe the antiseizure medication gabapentin and the overactive bladder medication oxybutynin to help ease hot flash symptoms.

Cognitive behavioral therapy. Another nonhormonal treatment that’s increasingly being embraced by doctors and patients is cognitive behavioral therapy (CBT), a common type of talk therapy. Several studies, including gold-standard randomized controlled trials, have demonstrated its effectiveness across a range of common symptoms, and it’s a recommended form of nonhormone treatment from the North American Menopause Society.  

“This is very powerful,” Patil says. “It’s been shown to significantly reduce hot flashes, improve sleep, mood and quality of life during the menopause transition.”

About 8 percent of women surveyed by AARP report trying psychological or psychiatric therapy to help with their symptoms. “I think it’s underutilized but can be utilized more in the health care system if it’s available to patients,” Patil says.

Be mindful of marketing claims

The growing list of effective treatment options is no doubt beneficial for women. But with menopause having its “moment,” doctors say patients need to be more cautious than ever.

Social media is filled with posts promoting products — gummies, pills, powders and more — that promise to relieve menopausal symptoms.

“Menopause treatment is such big business right now,” Shen says. “And there are a lot of unethical players out there” targeting women who are having “horrific symptoms.”

Shen says to keep in mind that supplements are not approved by the FDA — neither are the claims on their bottles. “Women will spend a lot of money to buy them only to find that they don’t work,” she says.

What’s more, supplements, even common ones, can cause side effects and can interact with other medications you may be taking, Shen says, so it’s really important to talk to your doctor before trying something new.

Forty-five percent of women surveyed by AARP say they have tried supplements to alleviate their menopause symptoms. AARP’s report finds that women, on average, are spending nearly $150 a year on supplements for menopause. 

Don’t shy away from talking to your doctor

For so long, many women have felt as though they can’t bring up menopause symptoms with their doctors, or that they shouldn’t because it’s just part of getting older.

“Really until now — and still — I think there’s a lot of discomfort with the idea of talking about it and feeling comfortable with asking for help,” Patil says. However, “women are feeling a little bit more relaxed about coming out of the woodwork and asking their doctors,” she says.

Here are some tips for starting the conversation:

• Ask your doctor if the symptoms you are experiencing are due to menopause or something else, Shen says. For example, hot flashes may be due to a thyroid issue; mood swings could be depression.

• Don’t let yourself be dismissed, Shen adds. If you find that’s the case, look for another provider, especially one who specializes in treating menopausal women. (The North American Menopause Society has a search function you can use.)

• Outline all of the symptoms you are experiencing and when they started, Patil says — almost like a diary, so your physician can get a clear picture of what’s happening.

• Educate yourself on menopause, “but be careful what you choose to read,” Shen says. Misinformation abounds, so be sure to get your information from reliable sources.

“[Patients] should feel empowered to really ask questions,” Patil says. The good news, she adds, is that with more people talking about menopause, “I feel like maybe they won’t be as shy or feel embarrassed or feel like they can’t talk to their doctor about it.”